Follow-up imaging of traumatic vertebral artery dissections is unnecessary in asymptomatic patients

Journal of Vascular Surgery
M Caroline NallyR James Valentine

Abstract

Routine computed tomography (CT) imaging in trauma patients has led to increased recognition of blunt vertebral artery injuries (BVIs). We sought to determine the prevalence of strokes, injury progression, and need for intervention in patients with BVI. Consecutive patients presenting with BVI during 2 years were identified from the institutional trauma registry. Inpatient records, imaging studies, and follow-up data were reviewed in detail from the electronic medical record. There were 76 BVIs identified in 70 patients (64% male; mean age, 47 ± 19 years); bilateral injuries occurred in 6 patients. Five patients who arrived at the hospital intubated had evidence of posterior circulation infarcts on admission CT, whereas one additional patient had evidence of a posterior circulation infarct attributed to complications of late spinal surgery. Four of the five patients with infarcts on admission CT survived to discharge, but only one had residual stroke symptoms. Minor (grade 1 or grade 2) injuries occurred in 25 (36%) patients; severe (grade 3 or grade 4) injuries occurred in 45 (64%). Twelve patients died of associated injuries (eight with severe BVI, four with minor BVI). Stepwise logistic regression analysis selected age (odds...Continue Reading

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Citations

May 17, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Javier M FigueroaRonald Benveniste
Oct 22, 2020·Clinical Spine Surgery : a Spine Publication·Zachariah W PinterWilliam B Roach

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